Skin Tightening · Richmond Hill
XERF in Richmond Hill.
RF that reaches
where it needs to.
XERF is the world's first multifrequency monopolar radiofrequency system, developed by Cynosure Lutronic and FDA-cleared in August 2025. It is now available at Skin Trek in Richmond Hill.
What makes XERF different from conventional RF devices is not marketing language — it is a genuine technical distinction. Every other monopolar RF system operates at a single frequency (typically 6.78 MHz), which limits how precisely energy can be delivered at different tissue depths. XERF combines 6.78 MHz and 2 MHz simultaneously, allowing it to reach the shallow, middle, and deep tissue layers in a single treatment. This includes the fibrous septa — the structural connective tissue that, when contracted, produces lasting tightening effects.
No numbing cream. No needles. No downtime.
"What interests me clinically about XERF is the depth access. Conventional monopolar RF tightens the dermis. XERF reaches the structural layer. The histological evidence — actual tissue analysis after treatment — shows measurable changes in collagen architecture at multiple depths. That is not a claim most RF devices can make honestly."
The two-frequency difference
Radiofrequency energy travels differently through tissue depending on its frequency. Higher frequencies (6.78 MHz) are absorbed more superficially. Lower frequencies (2 MHz) penetrate deeper. Conventional RF devices use one frequency and accept a fixed depth ceiling. XERF delivers both simultaneously — treating three distinct depth levels in a single pass.
Surface skin quality, texture refinement, and collagen remodelling in the upper layers.
Deeper collagen stimulation and firming where skin laxity originates.
Structural tightening of the connective tissue layer — where lasting changes happen.
XERF also uses Wave Fit pulse technology and integrated cryogen cooling to regulate energy delivery and maintain surface temperature throughout the treatment. This is what makes the treatment possible without anaesthetic — the surface is protected while the deep tissue is heated to therapeutic temperatures.
What XERF treats
Facial laxity. Loose or sagging skin in the cheeks, jowls, and lower face responds to XERF's structural heating. The fibrous septa contraction produces an immediate firming effect alongside the longer-term collagen remodelling response.
Jawline definition. As the structural layer tightens, the jawline becomes more defined and the appearance of jowling reduces. This is a genuine structural change, not surface tension.
Neck laxity. The neck and sub-chin area are well-suited to XERF treatment, particularly for patients who are not candidates for Ultherapy or who want a complementary approach alongside it.
Overall skin quality. The RF energy's photothermal effect stimulates new collagen formation throughout the treated area, improving skin firmness, texture, and resilience over time.
Technical specifications
XERF vs. other energy devices
| XERF | Thermage | Ultherapy | |
|---|---|---|---|
| Technology | Monopolar RF, dual frequency | Monopolar RF, single frequency | Focused ultrasound |
| Frequencies | 6.78 MHz + 2 MHz | 6.78 MHz only | N/A (ultrasound) |
| Deepest target | Fibrous septa | Deep dermis | SMAS layer |
| Tissue visualisation | No | No | Yes (real-time imaging) |
| Numbing required? | No | Sometimes | Topical recommended |
| Downtime | None | Minimal | Minimal |
| FDA clearance | 2025 | Long established | Long established |
| Evidence base | Growing — newer device | Extensive | Extensive |
For a deeper comparison of energy-based skin tightening devices, see our clinical guide: Ultherapy vs. Thermage vs. Sofwave — the honest version.
Pricing at Skin Trek
Frequently asked questions
Is XERF painful?
Most patients describe it as a warm, pulsing sensation — tolerable without numbing cream. The integrated cryogen cooling system maintains surface temperature throughout the treatment, which is what allows it to be delivered comfortably. Sensitivity varies by patient and treatment area. We have found it significantly more comfortable than first-generation RF devices for most patients.
How does XERF compare to Thermage?
Both are monopolar RF devices. The key technical difference is frequency: Thermage uses a single 6.78 MHz frequency, which limits its depth ceiling. XERF combines 6.78 MHz with 2 MHz, allowing it to reach the fibrous septa — the structural connective tissue layer that Thermage cannot consistently access. In practical terms this means XERF can produce structural tightening that goes beyond what single-frequency devices achieve. The evidence base for XERF is newer; Thermage has decades of published data. Both are legitimate devices with different depth profiles.
How is XERF different from Ultherapy?
Different technologies, different mechanisms, different patient profiles. Ultherapy uses focused ultrasound with real-time tissue visualisation, targets the SMAS layer, and is particularly effective for structural lifting in patients with significant laxity. XERF uses radiofrequency energy to treat multiple tissue depths simultaneously — it is more comfortable, requires no numbing, and reaches the fibrous septa through a different mechanism. They are complementary rather than competing, and can be used in combination in appropriate patients.
How many sessions do I need?
Most patients start with a single session and assess results at 3 to 6 months when the full collagen remodelling response is visible. Some patients benefit from a course of 2 to 3 sessions, particularly for more significant laxity. Maintenance sessions every 12 to 18 months are typical for patients who want to sustain their results. We discuss the appropriate plan at consultation.
Can XERF be combined with injectables or other devices?
Yes. XERF addresses laxity and structural tightening. Sculptra and fillers address volume. Ultherapy addresses deep lifting. These treat different aspects of facial aging and are genuinely complementary. Sequencing and spacing matters — we discuss this at consultation and recommend an approach based on your specific combination of concerns.
Is XERF suitable for all skin types?
Yes. Radiofrequency energy is not absorbed by melanin, which means XERF does not carry the pigmentation risks associated with laser treatments in darker skin types. It is safe and effective across all Fitzpatrick skin types. This makes it a particularly good option for patients of East Asian, South Asian, or Middle Eastern background who may be more cautious about laser treatments.
XERF is a new device and not every patient is the right candidate for it. A free consultation is the right starting point — an honest assessment of what it can realistically achieve for your specific concerns.
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